title: Exploratory benchtop study evaluating the use of surgical design and simulation in fibula free flap mandibular reconstruction.
abstract: BACKGROUND
  Surgical design and simulation (SDS) is a useful tool to help surgeons visualize the anatomy of the patient and perform operative maneuvers on the computer before implementation in the operating room. While these technologies have many advantages, further evidence of their potential to improve outcomes is required. The present benchtop study was intended to identify if there is a difference in surgical outcome between free-hand surgery completed without virtual surgical planning (VSP) software and preoperatively planned surgery completed with the use of VSP software.
  
  
  METHODS
  Five surgeons participated in the study. In Session A, participants were asked to do a free-hand reconstruction of a 3d printed mandible with a defect using a 3d printed fibula. Four weeks later, in Session B, the participants were asked to do the same reconstruction, but in this case using a preoperatively digitally designed surgical plan. Digital registration computer software, hard tissue measures and duration of the task were used to compare the outcome of the benchtop reconstructions.
  
  
  RESULTS
  The study revealed that: (1) superimposed images produced in a computer aided design (CAD) software were effective in comparing pre and post-surgical outcomes, (2) there was a difference, based on hard tissue measures, in surgical outcome between the two scenarios and (3) there was no difference in the time it took to complete the sessions.
  
  
  CONCLUSIONS
  The study revealed that the participants were more consistent in the preoperatively digitally planned surgery than they were in the free hand surgery.
authors.affiliation: Institute for Reconstructive Sciences in Medicine, 1W-02, 16940-87 Avenue Misericordia Community Hospital, Edmonton, AB T5R 4H5, Canada. heather.logan2@albertahealthservices.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Logan
authors.forename: Johan
authors.initials: J
authors.lastname: Wolfaardt
authors.forename: Pierre
authors.initials: P
authors.lastname: Boulanger
authors.forename: Bill
authors.initials: B
authors.lastname: Hodgetts
authors.forename: Hadi
authors.initials: H
authors.lastname: Seikaly
mesh_terms: D017076:Computer-Aided Design; D058752:Free Tissue Flaps; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008334:Mandible / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012984:Software; D014584:User-Computer Interface